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Chan KKY, Yeung NCY, Mo PKH, Yang X. Common stressors, coping processes, and professional help-seeking of medical professionals in Hong Kong: A qualitative study. J Health Psychol 2024; 29:891-904. [PMID: 38160404 DOI: 10.1177/13591053231218658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Despite the high prevalence of perceived stress and mental health problems among medical professionals (MPs), their professional help-seeking is extremely low. This qualitative study explored MPs' stressors, stress-coping, barriers and facilitators of professional help-seeking. 10 MPs (30% male, Mage = 34.8 years) were recruited by purposive-sampling for views from different roles/settings. Thematic analyses revealed five central stressors: emerging novel diseases, challenges from technology-advancement, patient-communication difficulties, lack of workplace mental health care culture, excessive workload/manpower shortage. Participants predominantly used peer support/supervision and de-stress activities for stress-coping. Five factors affecting professional help-seeking were time constraint versus flexibility, mental health stigma versus de-stigmatization, concern over confidentiality/anonymity versus sense of privacy, worry about damage on professional role versus least work disruption, doubts of service providers versus perceived efficacy. All participants indicated a preference for online mental health service delivery. Results reflected unmet needs and service gaps from MPs' perspectives for the development of future interventions.
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Affiliation(s)
| | | | | | - Xue Yang
- The Chinese University of Hong Kong, Hong Kong
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2
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Güney E, Aydemir AF, Iyit N, Alkan Ö. Gender differences in psychological help-seeking attitudes: a case in Türkiye. Front Psychol 2024; 15:1289435. [PMID: 38515972 PMCID: PMC10954894 DOI: 10.3389/fpsyg.2024.1289435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Background/aim Mental disorders pose a substantial public health challenge within the overall disease burden. This study aims to determine the factors associated with seeking psychological help among individuals experiencing depression according to gender differences in Türkiye. Methods The study utilized microdata from Türkiye Health Survey conducted by the Turkish Statistical Institute in 2016, 2019, and 2022. Binary logistic regression analysis was employed to determine the factors associated with seeking psychological help. Results The study's findings reveal that variables such as survey year, age, education level, employment status, general health status, disease status, depression status, day service status in the hospital, daily activity status, tobacco use status, and alcohol use status are associated with the status of receiving psychological help. Conclusion Gender-specific analysis indicated variations in the significance and impact of these variables among individuals seeking psychological help. In the development of preventive strategies for mental health protection, special attention should be given to factors associated with the psychological help-seeking behavior of both women and men. Prioritizing and addressing these factors will contribute to more effective mental health interventions.
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Affiliation(s)
- Esra Güney
- Department of Econometrics, Faculty of Political Sciences, Sakarya University, Sakarya, Türkiye
| | - Ahmet Fatih Aydemir
- Department of International Trade and Logistics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Türkiye
| | - Neslihan Iyit
- Department of Statistics, Faculty of Science, Selçuk University, Konya, Türkiye
| | - Ömer Alkan
- Department of Econometrics, Faculty of Economics and Administrative Sciences, Ataturk University, Erzurum, Türkiye
- Master Araştırma Eğitim ve Danışmanlık Hizmetleri Ltd. Şti., Erzurum, Türkiye
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3
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Huang R, Peng X, Yu S, Tian Y, Gao C. Attitudes and intentions toward seeking professional psychological help among Chinese healthcare workers during the COVID-19 pandemic. Front Psychiatry 2023; 14:1223895. [PMID: 37779617 PMCID: PMC10539927 DOI: 10.3389/fpsyt.2023.1223895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Background It has been suggested that healthcare workers (HCWs) are experiencing massive stressors that threaten their mental health during the COVID-19 pandemic, but little is known about their attitudes and intentions toward seeking professional psychological help. This study aimed to investigate the attitudes and intentions of Chinese HCWs toward seeking professional psychological help during the COVID-19 pandemic and the associated factors. Methods A total of 1,224 Chinese HCWs working in hospitals were recruited online from 12 hospitals in Hunan province in China for a survey conducted in November 2022. The Chinese version of the attitudes toward seeking professional psychological help scale-short form (ATSPPH-SF) and the general help-seeking questionnaire (GHSQ) were separately used to assess the attitudes and intentions of the respondents toward seeking professional psychological help. Demographic and socio-psychological data were collected using a self-developed questionnaire, the perceived social support scale, the self-stigma of seeking help scale, and the patient health questionnaire-9 scale. Results The 1,208 HCWs in the final analysis showed relatively negative attitudes and low intentions toward seeking professional psychological help during the COVID-19 pandemic. Results of the multiple linear regression analysis showed that female sex (p = 0.031), experience of psychological learning (p < 0.001), and social support (p < 0.001) had a positive predictive effect on the attitudes of these HCWs toward seeking professional psychological help, whereas self-stigma of seeking help (p < 0.001) and depressive symptoms (p < 0.001) exerted negative effects. Moreover, experience of psychological learning (p = 0.004) and social support (p < 0.001) had a positive predictive effect on the intentions of these HCWs toward seeking professional psychological help, whereas divorced marital status (p = 0.011) and self-stigma of seeking help (p < 0.001) exerted negative effects. Conclusion The overall attitudes and intentions of HCWs toward seeking professional psychological help were not optimistic. Effective interventions targeted at influencing factors should be formulated to promote the professional psychological help-seeking attitudes and intentions of HCWs who are at risk of developing mental health problems.
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Affiliation(s)
- Ruirui Huang
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Xiaoyan Peng
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Shuai Yu
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Yumei Tian
- School of Nursing, Hunan University of Medicine, Huaihua, China
| | - Chuanying Gao
- Department of Nursing, The First Affiliated Hospital of Hunan University of Medicine, Huaihua, China
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Petrie K, Zeritis S, Phillips M, Chen N, Shand F, Spittal MJ, Harvey SB. Suicide among health professionals in Australia: A retrospective mortality study of trends over the last two decades. Aust N Z J Psychiatry 2023; 57:983-993. [PMID: 36655674 DOI: 10.1177/00048674221144263] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To examine the relative risk of suicide among healthcare professionals compared to other occupations and examine changes in suicide rates over time. METHODS Suicide cases were identified using the National Coronial Information System and were included if they were recorded as a death by intentional self-harm between 2001 and 2017 and were by an employed adult aged 20-69 with a known occupation at the time of death. Suicide methods were reported descriptively. Workforce data at the population level was extracted from the Australian Bureau of Statistics 2011 Census. Age-standardised suicide rates per 100,000 person-years for each of the four occupational groups were calculated using direct standardisation and using the Australian Bureau of Statistics population-level data from the 2011 Census. Negative binomial regression was used to estimate suicide risk by healthcare employment status and profession, to investigate differences by sex and to examine trends in suicide rates over time, using rate ratios and 95% confidence intervals. RESULTS Healthcare professionals were at increased risk of suicide compared to other occupations (rate ratio = 1.30, 95% confidence interval = [1.19, 1.42], p < 0.001), controlling for age, sex and year of death. Nurses and midwives were identified as being at significantly increased risk of suicide (rate ratio = 1.95, 95% confidence interval = [1.73, 2.19], p < 0.001). Suicide rates among female medical practitioners increased substantially over time (p = 0.01). CONCLUSION Health professionals are at significantly increased risk of suicide, though the relative risk of different groups is changing over time. There has been a substantial increase in the risk of suicide among female medical practitioners with rates of suicide in this group more than doubling over the last two decades. Findings highlight the need for targeted suicide prevention initiatives for healthcare professionals.
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Affiliation(s)
- Katherine Petrie
- Black Dog Institute, Randwick, NSW, Australia
- University of New South Wales Sydney, Sydney, NSW, Australia
| | | | | | - Nicola Chen
- Black Dog Institute, Randwick, NSW, Australia
- University of New South Wales Sydney, Sydney, NSW, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Fiona Shand
- Black Dog Institute, Randwick, NSW, Australia
- University of New South Wales Sydney, Sydney, NSW, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
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Huang CLC. Underrecognition and un-dertreatment of stress-related psychiatric disorders in physicians: Determinants, challenges, and the impact of the COVID-19 pandemic. World J Psychiatry 2023; 13:131-140. [PMID: 37123097 PMCID: PMC10130963 DOI: 10.5498/wjp.v13.i4.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/12/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023] Open
Abstract
Medical practitioners’ duties are highly stressful and performed in a particularly challenging and competitive work environment. Stress and burnout among physicians have emerged as a worldwide public health problem in recent years. A high level of distress and burnout can lead to clinically significant behavioral health problems, such as stress-related psychiatric disorders. Mounting evidence shows that physicians have higher risks of insomnia, anxiety, and depression than the general population, especially during the coronavirus disease 2019 pandemic. However, the behavioral health problems of these vulnerable healthcare professionals are noteworthy for being underrecognized and undertreated. In this mini-review, we summarize the current progress of studies on the prevalence and determinants of distress and stress-related psychiatric disorders among phy-sicians and their healthcare-seeking behaviors. We discuss future research directions and the clinical approach that may maximize self-awareness and promote prompt and adequate treatment for clinically significant behavioral health problems of physicians.
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Affiliation(s)
- Charles Lung-Cheng Huang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 710, Taiwan
- Department of Medicinal and Applied Chemistry, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Yamauchi T, Shimazaki T, Yanagisawa H, Suka M. Formal and informal help-seeking intentions/behaviors among students and workers during the COVID-19 pandemic: a scoping review. Environ Health Prev Med 2023; 28:53. [PMID: 37743523 PMCID: PMC10519802 DOI: 10.1265/ehpm.23-00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Students and workers have been subjected to increased levels of psychological distress due to the quarantine policy and containment measures during the COVID-19 pandemic. This scoping review aimed to present an overview of published evidence regarding formal and informal help-seeking intentions/behaviors for non-mental health-related issues as well as mental health-related issues among students and workers during the pandemic. METHODS In June 2022, we searched MEDLINE, APA PsycNet, and CINAHL for articles reporting the state of help-seeking intentions/behaviors among students and workers during the pandemic. Peer-reviewed original articles published in English were selected. RESULTS In total, 150 articles were identified, and 12 articles were selected for final analysis after removing articles that met the exclusion criteria. Three studies targeted university students, and nine targeted healthcare workers. Study settings were restricted to Western countries and China. Of the 12 studies, 11 were observational and predominantly cross-sectional studies. Two longitudinal studies using student samples suggested that university students became more reluctant to seek help from both formal and informal sources during the COVID-19 pandemic compared to before, despite the increased need for support during the pandemic. Among healthcare workers, the proportions of those who sought help from formal sources in person were low (7-26%), even among those with mental health issues, despite the increase in the need for mental health services. One randomized controlled study reported that a brief video-based intervention increased treatment-seeking intentions among healthcare workers in the intervention group compared with the non-intervention group. CONCLUSIONS The present review revealed that, although most studies included in the final analysis were cross-sectional, intentions/behaviors to seek help from both formal and informal sources decreased among university students, even those with mental health issues. Among healthcare workers, while the frequency of help-seeking from formal sources in person was low, a brief online intervention was suggested to be useful for promoting help-seeking from formal sources. During public health crises such as the COVID-19 pandemic, system and infrastructure development of online help-seeking services could potentially promote formal and informal help-seeking intentions/behaviors for diverse issues, including non-mental health-related issues, among university students and healthcare workers/providers.
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Affiliation(s)
- Takashi Yamauchi
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Takashi Shimazaki
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Hiroyuki Yanagisawa
- The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo 105-8461, Japan
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7
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Connolly CE, Norris K, Dawkins S, Martin A. Barriers to mental health help-seeking in veterinary professionals working in Australia and New Zealand: A preliminary cross-sectional analysis. Front Vet Sci 2022; 9:1051571. [PMID: 36406072 PMCID: PMC9671929 DOI: 10.3389/fvets.2022.1051571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
Despite higher reported rates of mental ill-health than the general population, professionals working in the animal care industry have low reported rates of help-seeking behavior. Potential factors involved in veterinary professionals' reluctance to seek help include stigma toward mental ill-health, practical barriers to accessing supports, and a cultural normalization of symptoms in the industry. This preliminary study sought to explore these factors in a sample of veterinarians, veterinary nurses, and veterinary technicians and examine effects of gender, years' experience, and practice location. A total of 408 veterinary professionals working in Australia and New Zealand completed an online survey between June and December 2021 measuring perceived stigma, practical barriers to mental health help-seeking, perceptions of normalized psychopathology and sickness presenteeism. Results indicated moderate levels of both perceived stigma and barriers to mental health help-seeking. Interestingly, psycho/pathology (e.g., burnout, fatigue, and sickness presenteeism) was perceived to be a normalized aspect of the profession by majority of respondents. Although no effect of gender or geographic location were observed, stage of career did have an effect on findings. Early career veterinary professionals were identified as more vulnerable to perceived stigma and barriers to care. The practical and research implications of the findings are discussed and include the need for mental health to be more centrally incorporated into the veterinary curriculum and professional development. Also discussed is an agenda for future research aimed at improving the mental health and wellbeing of professionals working in the animal care industry.
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Affiliation(s)
- Caitlin Elizabeth Connolly
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
- *Correspondence: Caitlin Elizabeth Connolly
| | - Kimberley Norris
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Sarah Dawkins
- School of Psychological Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Angela Martin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
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Pham TV, Kim HH, Kritzer MD, Mankad M, Gagliardi JP. Perceived Stalking by a Patient: An Educational Case Report. J Grad Med Educ 2022; 14:394-397. [PMID: 35991111 PMCID: PMC9380637 DOI: 10.4300/jgme-d-21-01201.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Tony V. Pham
- Tony V. Pham, MD, MScGH, is Instructor, Massachusetts General Hospital
| | - Hyun-Hee Kim
- Hyun-Hee Kim, MD, is Instructor, Massachusetts General Hospital
| | - Michael D. Kritzer
- Michael D. Kritzer, MD, PhD, is Instructor, Massachusetts General Hospital
| | - Mehul Mankad
- Mehul Mankad, MD, is Adjunct Assistant Professor, Duke University Medical Center
| | - Jane P. Gagliardi
- Jane P. Gagliardi, MD, MHS, is Director, Medicine-Psychiatry Residency Training Program, Duke University Medical Center
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9
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Bismark M, Smallwood N, Jain R, Willis K. Thoughts of suicide or self-harm among healthcare workers during the COVID-19 pandemic: qualitative analysis of open-ended survey responses. BJPsych Open 2022; 8:e113. [PMID: 35699151 PMCID: PMC9203357 DOI: 10.1192/bjo.2022.509] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Healthcare workers are at higher risk of suicide than other occupations, and suicidal thoughts appear to have increased during the COVID-19 pandemic. AIMS To understand the experiences of healthcare workers with frequent thoughts of suicide or self-harm during the pandemic, including factors that contributed to their distress, and the supports that they found helpful. METHOD We used content analysis to analyse free-text responses to the Australian COVID-19 Frontline Healthcare Workers Study, from healthcare workers who reported frequent thoughts that they would be better off dead or of hurting themselves, on the Patient Health Questionnaire-9. RESULTS A total of 262 out of 7795 healthcare workers (3.4%) reported frequent thoughts of suicide or self-harm in the preceding 2 weeks. They described how the pandemic exacerbated pre-existing challenges in their lives, such as living with a mental illness, working in an unsupportive environment and facing personal stressors like relationship violence or unwell family members. Further deterioration in their mental health was triggered by heavier obligations at home and work, amid painful feelings of loneliness. They reported that workplace demands rose without additional resources, social and emotional isolation increased and many healthful activities became inaccessible. Tokenistic offers of support fell flat in the face of multiple barriers to taking leave or accessing professional help. Validation of distress, improved access to healthcare and a stronger sense of belonging were identified as helpful supports. CONCLUSIONS These findings highlight the need for better recognition of predisposing, precipitating, perpetuating and protective factors for thoughts of suicide and self-harm among healthcare workers.
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Affiliation(s)
- Marie Bismark
- Centre for Health Policy, The University of Melbourne, Australia
| | - Natasha Smallwood
- Department of Respiratory Medicine, The Alfred Hospital, Australia; and Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, The Alfred Hospital and Monash University, Australia
| | - Ria Jain
- Faculty of Medicine, Nursing and Health Sciences, Monash University Clayton, Australia
| | - Karen Willis
- Institute for Health and Sport, Victoria University, Australia
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10
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Petrie K, Stanton K, Gill A, Simmons J, Harvey SB. Effectiveness of a multi-modal hospital-wide doctor mental health and wellness intervention. BMC Psychiatry 2022; 22:244. [PMID: 35387644 PMCID: PMC8983801 DOI: 10.1186/s12888-022-03908-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Doctors report high rates of workplace stress and are at increased risk of mental health disorders. However, there are few real-world studies evaluating the effectiveness of interventions aimed at addressing workplace risk factors and improving doctors' mental health in a hospital setting. This study was conducted over two years (2017-2019) to assess the effects of a multi-modal intervention on working conditions doctors' mental health and help-seeking for mental health problems in two Australian teaching hospitals. METHODS The multimodal intervention consisted of organisational changes, such as reducing unrostered overtime, as well as strategies for individual doctors, such as mental health training programs. Hospital-based doctors at all career stages were eligible to participate in two cross-sectional surveys. 279 doctors completed the baseline survey (19.2% response rate) and 344 doctors completed the follow-up survey (31.3% response rate). A range of workplace risk and protective factors, mental health (psychological distress and suicidal ideation) and help-seeking outcomes were assessed. RESULTS There were significant improvements in key workplace protective factors, with small effects found for doctors' job satisfaction, stress, work-life balance and perceived workplace support and a significant reduction in workplace risk factors including a moderate reduction in reported bullying behaviour between baseline to follow-up (job satisfaction p < 0.05, all other outcomes p < 0.01). However, no significant changes in doctors' mental health or help-seeking outcomes were found over the intervention period. CONCLUSION Following the implementation of individual and organisational-level strategies in two Australian tertiary hospitals, doctors reported a reduction in some key workplace stressors, but no significant changes to their mental health or help-seeking for mental health problems. Further research is warranted, particularly to determine if these workplace changes will lead to improved mental health outcomes for doctors once maintained for a longer period.
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Affiliation(s)
- Katherine Petrie
- grid.1005.40000 0004 4902 0432Black Dog Institute, University of New South Wales, Randwick, NSW 2031 Australia ,grid.1005.40000 0004 4902 0432School of Psychiatry, University of New South Wales, Sydney, NSW 2000 Australia
| | - Kelly Stanton
- grid.416398.10000 0004 0417 5393St George Hospital, Kogarah, NSW 2217 Australia ,grid.416100.20000 0001 0688 4634The Royal Brisbane and Women’s Hospital, Herston, Brisbane, QLD 4006 Australia
| | - Aneesha Gill
- grid.416398.10000 0004 0417 5393St George Hospital, Kogarah, NSW 2217 Australia ,grid.460648.80000 0004 0626 0356Sutherland Hospital, Caringbah, NSW 2229 Australia ,grid.1005.40000 0004 4902 0432University of New South Wales, Sydney, NSW 2000 Australia
| | - Jennifer Simmons
- grid.416398.10000 0004 0417 5393St George Hospital, Kogarah, NSW 2217 Australia
| | - Samuel B. Harvey
- grid.1005.40000 0004 4902 0432Black Dog Institute, University of New South Wales, Randwick, NSW 2031 Australia
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Sanatkar S, Counson I, Mackinnon A, Bartholomew A, Glozier N, Harvey S. Preliminary investigation of Shift, a novel smartphone application to support junior doctors’ mental health and wellbeing: Examination of symptom progression, usability, and acceptability after one month of use (Preprint). J Med Internet Res 2022; 24:e38497. [PMID: 36129745 PMCID: PMC9536518 DOI: 10.2196/38497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/25/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Shift is a novel smartphone app for providing a digital-first mental health resource to junior doctors. It contains psychoeducational material, cognitive behavioral modules, guided mediations, information on common work stressors, and a section on help-seeking options for psychological problems through workplace and private avenues. Objective This study aimed to conduct a preliminary investigation of the use and potential effectiveness of Shift on depressive and anxiety symptoms (primary outcomes) and work and social functioning, COVID-19 safety concerns, and help seeking (secondary outcomes). This study also sought feedback on whether Shift was seen as an acceptable tool. Methods Junior doctors in New South Wales, Australia, were approached through promotional activities from the Ministry of Health, specialist medical colleges, and social media advertisements between June and August 2020. Consenting participants provided web-based baseline data, used the Shift app for 30 days, and were asked to complete a poststudy web-based questionnaire. Outcomes were analyzed under the intention-to-treat principle. Results A total of 222 female (n=156, 70.3%; mean age 29.2, SD 4.61 years) junior doctors provided full baseline data. Of these, 89.2% (198/222) downloaded the app, logged into the app approximately 6 times (mean 5.68, SD 7.51), completed 4 in-app activities (mean 3.77, SD 4.36), and spent a total of 1 hour on in-app activities (mean 52:23, SD 6:00:18) over 30 days. Postintervention and app use data were provided by 24.3% (54/222) of participants. Depressive and anxiety symptoms significantly decreased between the pre- and postassessment points as expected; however, physicians’ COVID-19 safety concerns significantly increased. Work and social functioning, COVID-19 concerns for family and friends, and help seeking did not change significantly. There was no significant relationship between symptom changes and app use (number of log-ins, days between first and last log-in, and total activity time). Most poststudy completers (31/54, 57%) rated Shift highly or very highly. Conclusions Despite high levels of nonresponse to the poststudy assessment and increases in COVID-19 safety concerns, junior doctors who used the app reported some improvements in depression and anxiety, which warrant further exploration in a robust manner.
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Affiliation(s)
- Samineh Sanatkar
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
| | - Isabelle Counson
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
| | | | | | - Nick Glozier
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Samuel Harvey
- Black Dog Institute, Randwick, Australia
- School of Psychiatry, Faculty of Medicine, University of New South Wales Sydney, Kensington, Australia
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Vilovic T, Bozic J, Zuzic Furlan S, Vilovic M, Kumric M, Martinovic D, Rusic D, Rada M, Tomicic M. Mental Health Well-Being and Attitudes on Mental Health Disorders among Family Physicians during COVID-19 Pandemic: A Connection with Resilience and Healthy Lifestyle. J Clin Med 2022; 11:438. [PMID: 35054130 PMCID: PMC8778288 DOI: 10.3390/jcm11020438] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/16/2022] Open
Abstract
Family physicians (FPs) are exposed to high amounts of stress, and could be susceptible to the development of mental health disorders (MHD), especially after the emergence of the COVID-19 pandemic. The aim of the current study was to assess MHD history, attitudes toward MHDs and stress-coping strategies in FPs. An additional goal was to estimate their comprehensive well-being and investigate connections with resilience and a healthy lifestyle. A total of 483 FPs submitted their responses via online survey. MHD attitudes were assessed with the according questionnaires, while burnout levels, healthy lifestyle, resilience, job and life satisfaction were estimated with validated scales. Results have shown that 32.5% of FPs disclosed positive MHD history, while 68.7% used professional help. Resilience and healthy lifestyle levels were significantly higher in MHD negative FPs (p < 0.001), while burnout levels were lower (p < 0.001). Moreover, healthy lifestyle (β = 0.03, p < 0.001) was an independent correlate of resilience, while healthy lifestyle (β = -0.35, p < 0.001, and resilience (β = -1.82, p < 0.001) were of burnout levels. Finally, resilience (OR = 0.387, p < 0.001) and healthy lifestyle (OR = 0.970, p = 0.021) were shown as independent predictors of positive MHD history status. Strong promotion and education of FP population regarding resilience and healthy lifestyle should be utilized in practice in order to alleviate the possibility of mental health disturbances and the according consequences.
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Affiliation(s)
- Tina Vilovic
- Department of Family Medicine, University of Split School of Medicine, 21000 Split, Croatia; (T.V.); (S.Z.F.); (M.R.)
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.B.); (M.V.); (M.K.); (D.M.)
| | - Sanja Zuzic Furlan
- Department of Family Medicine, University of Split School of Medicine, 21000 Split, Croatia; (T.V.); (S.Z.F.); (M.R.)
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.B.); (M.V.); (M.K.); (D.M.)
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.B.); (M.V.); (M.K.); (D.M.)
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (J.B.); (M.V.); (M.K.); (D.M.)
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, 21000 Split, Croatia;
| | - Marko Rada
- Department of Family Medicine, University of Split School of Medicine, 21000 Split, Croatia; (T.V.); (S.Z.F.); (M.R.)
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
| | - Marion Tomicic
- Department of Family Medicine, University of Split School of Medicine, 21000 Split, Croatia; (T.V.); (S.Z.F.); (M.R.)
- Department of Family Medicine, Split-Dalmatia Health Center, 21000 Split, Croatia
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13
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Counson I, Bartholomew A, Crawford J, Petrie K, Basarkod G, Moynihan V, Pires J, Cohen R, Glozier N, Harvey S, Sanatkar S. Development of the Shift Smartphone App to Support the Emotional Well-Being of Junior Physicians: Design of a Prototype and Results of Usability and Acceptability Testing. JMIR Form Res 2021; 5:e26370. [PMID: 34860662 PMCID: PMC8686399 DOI: 10.2196/26370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/09/2021] [Accepted: 10/21/2021] [Indexed: 01/20/2023] Open
Abstract
Background Junior physicians report higher levels of psychological distress than senior doctors and report several barriers to seeking professional mental health support, including concerns about confidentiality and career progression. Mobile health (mHealth) apps may be utilized to help overcome these barriers to assist the emotional well-being of this population and encourage help-seeking. Objective This study describes the development and pilot trial of the Shift mHealth app to provide an unobtrusive avenue for junior physicians to seek information about, and help for, well-being and mental health concerns, which is sensitive to workplace settings. Methods A 4-phase iterative development process was undertaken to create the content and features of Shift involving junior physicians using the principles of user-centered design. These 4 phases were—needs assessment, on the basis of interviews with 12 junior physicians; prototype development with user experience feedback from 2 junior physicians; evaluation, consisting of a pilot trial with 22 junior physicians to assess the usability and acceptability of the initial prototype; and redesign, including user experience workshops with 51 junior physicians. Results Qualitative results informed the content and design of Shift to ensure that the app was tailored to junior physicians’ needs. The Shift app prototype contained cognitive behavioral, mindfulness, value-based actions, and psychoeducational modules, as well as a tracking function that visualized patterns of daily variations in mood and health behaviors. Pilot-testing revealed possible issues with the organization of the app content, which were addressed through a thorough restructuring and redesign of Shift with the help of junior physicians across 3 user experience workshops. Conclusions This study demonstrates the importance of ongoing end user involvement in the creation of a specialized mHealth app for a unique working population experiencing profession-specific stressors and barriers to help-seeking. The development and pilot trial of this novel Shift mHealth app are the first steps in addressing the mental health and support-seeking needs of junior physicians, although further research is required to validate its effectiveness and appropriateness on a larger scale.
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Affiliation(s)
- Isabelle Counson
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | | | - Joanna Crawford
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Katherine Petrie
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Geetanjali Basarkod
- Institute for Positive Psychology and Education, Australian Catholic University, North Sydney, Australia
| | | | | | | | - Nicholas Glozier
- Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, Australia
| | - Samuel Harvey
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
| | - Samineh Sanatkar
- Black Dog Institute, Randwick, Australia.,School of Psychiatry, Faculty of Medicine, UNSW Sydney, Kensington, Australia
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14
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Ng APP, Chin WY, Wan EYF, Chen J, Lau CS. Prevalence of depression and suicide ideation in Hong Kong doctors: a cross-sectional study. Sci Rep 2021; 11:19366. [PMID: 34588512 PMCID: PMC8481547 DOI: 10.1038/s41598-021-98668-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/14/2021] [Indexed: 11/18/2022] Open
Abstract
Depression amongst physicians can lead to poor individual and institutional outcomes. This study examined the prevalence and factors associated with depression and suicidal ideation amongst doctors in Hong Kong. Doctors who graduated from medical school at the University of Hong Kong between 1995 and 2014 were invited to participate in a survey measuring depressive symptoms, suicidal ideation and thoughts of self-harm, lifestyle behaviours, career satisfaction and socio-demographic characteristics. Data collection occurred between January and April 2016. The prevalence of screened-positive depression was 16.0% and 15.3% of respondents reported having suicidal ideation. Amongst those with positive depression screening scores, less than half reported having a diagnosed mood disorder. Sleeping fewer hours was associated with higher depression scores (P < 0.001) and an increased odds of meeting the cut-off for depression (P < 0.001). Factors associated with suicidal ideation included being unmarried (P = 0.012) and sleeping fewer hours (P = 0.022). Hong Kong doctors appear to have high rates of undiagnosed depression, and high levels of depressive symptoms and suicidal ideations. There is a need for greater awareness of the morbidity due to depression and to promote better mental health help-seeking among physicians. Barriers to mental health help-seeking need to be addressed and appropriate resources allocated to reduce suffering.
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Affiliation(s)
- Amy Pui Pui Ng
- Department of Family Medicine and Primary Care, The University of Hong Kong-Shenzhen Hospital, 1 Haiyuan 1st Rd, Futian District, Shenzhen, 518053, Guangdong Province, China.,Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR. .,Li Ka Shing Faculty of Medicine, Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR.
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR.,Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, HKU, 2/F, Laboratory Block, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
| | - Julie Chen
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F., 161 Main Street, Ap Lei Chau Clinic, Ap Lei Chau, Hong Kong, Hong Kong SAR.,Li Ka Shing Faculty of Medicine, Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, 21 Sassoon Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
| | - Chak Sing Lau
- Department of Medicine Hong Kong, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Room 405B, 4/F, Professorial Block, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong SAR
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